COVID-19, AMR and India

Maybe it’s not a coincidence that India is today the site of the world’s largest COVID-19 outbreak and the world’s most prominent source of antimicrobial resistant (AMR) pathogens, a.k.a. ‘superbugs’. The former fiasco is the product of failures on multiple fronts – including policy, infrastructure, logistics, politics and even ideology, before we need to consider faster-spreading variants of the novel coronavirus. I’m not sure of all the factors that have contributed to AMR’s burgeoning in India; some of them are irrational use of broad-spectrum antibiotics, poor public hygiene, laws that disprivilege ecological health and subpar regulation of hospital practices.

But all this said, both the second COVID-19 wave and the rise of AMR have benefited from being able to linger in the national population for longer. The longer the novel coronavirus keeps circulating in the population, the more opportunities there are for new variants to appear; the longer pathogens are exposed repeatedly to antimicrobial agents in different environments, the more opportunities they have to develop resistance. And once these things happen, their effects on their respective crises are exacerbated by the less-than-ideal social, political and economic contexts in which they manifest.

Again, I should emphasise that if these afflictions have been assailing India for such a long time and in increasingly stronger ways, it’s because of many distinct, and some overlapping, forces – but I think it’s also true that the resulting permission for pathogens to persist, at scale to boot, makes India more vulnerable than other countries might be to problems of the emergent variety. And given the failures that give rise to this vulnerability, this can be one hell of a vicious cycle.

Curious Bends – where Indians come from, Irrawady dolphins, human spaceflight and more

1. A genetic history: Where do Indians come from?

“In 2005, K. Thangaraj and his colleagues at CCMB published their findings about the origin of Andaman islanders in the journal Science. The Onge turned out to have surprisingly unmixed origins. They had likely lived isolated in the islands since the arrival here of the first group of humans out of Africa. There were mutations in their mtDNA that were found nowhere else in the world. These mutations must have originated here and not spread. The Onge were an untouched link to the earliest humans who settled the planet.” (24 min read)

2. Oil spill in the Sunderbans threatens the endangered Irrawady dolphins

““Dolphins are at the top of the food chain so they will be affected sooner or later by eating the fish from these waters,” said Rubaiyat Mansur, Bangladesh head of the Wildlife Conservation Society. Mansur also worries about the more direct impact on the animals. “The oil slick collects at the confluences and meanders of the river and those are the places that the dolphins like to hang around in and look for prey,” he said. “Coming up in an oil slick, opening a blow hole and breathing in and breathing out won’t be a good idea because the air right above the oil slick will be quite toxic.”” (4 min read)

3. ISRO will launch its crew module on its first test flight on December 18

“While a capsule in orbit around Earth will re-enter with a velocity of over 28,000 km per hour, next week’s test will see the GSLV Mark III leave the crew module at a height of about 125 km with a velocity of around 19,000 km per hour. The crew module carries sensors that will make measurements of over 200 parameters during the flight, including the temperature, pressure and stress experienced at various points in the structure. “This flight will give us tremendous confidence in our design and provide important inputs for proceeding with development of the manned capsule,” observed S. Unnikrishnan Nair, project director for the Human Spaceflight Programme.” (4 min read)

4. Why are the women dying in India’s sterilisation camps?

“These dangerous conditions are not uncommon in sterilisation camps throughout India, claim women’s health activists. They say that such camps, favoured by the Indian government as a way to perform tubectomies on many women in one go, often exceed the prescribed limit for surgeries in a day, do not adequately sterilise the equipment used on patients, and do not provide counselling before operations or care afterwards. “This was waiting to happen,” Abhijit Das, a public health researcher at Delhi’s Centre for Health and Social Justice, told The BMJ.” (7 min read)

5. India is a breeding ground for the world’s super-bugs

“In the developing world, unregulated use of these drugs coupled with poor sanitation and health care are fueling the rise of resistant bacteria. In India, these factors have created the perfect breeding ground for so-called super bugs. Last year, more than 58,000 babies died from antibiotic-resistant infections.” (2 min read)

Chart of the week

“Japan is the third-largest economy after America and China. It is so wealthy that its regions boast the same economic heft as large countries. The entire economy of Brazil fits into the Kanto region that includes Tokyo, for example. Yet despite this wealth, Japan’s economic growth has been largely stagnant over a period known as the two “lost decades”. America’s GDP grew threefold during that time while China’s soared. After a short stint as prime minister in 2006-07, Shinzo Abe returned in 2012 calling for a bold, three-part plan of stimulus spending, monetary easing and structural reforms—the so-called “three arrows” of Abenomics.” The Economist has more.